{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T08:06:09Z","timestamp":1792829169042,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD074819"],"award-info":[{"award-number":["R01HD074819"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD092239"],"award-info":[{"award-number":["R01HD092239"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Upper esophageal sphincter opening (UESO), and laryngeal vestibule closure (LVC) are two essential kinematic events whose timings are crucial for adequate bolus clearance and airway protection during swallowing. Their temporal characteristics can be quantified through time\u2010consuming analysis of videofluoroscopic swallow studies (VFSS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to establish a model to predict the odds of penetration or aspiration during swallowing based on 15 temporal factors of UES and laryngeal vestibule kinematics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Manual temporal measurements and ratings of penetration and aspiration were conducted on a videofluoroscopic dataset of 408 swallows from 99 patients. A generalized estimating equation model was deployed to analyze association between individual factors and the risk of penetration or aspiration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results indicated that the latencies of laryngeal vestibular events and the time lapse between UESO onset and LVC were highly related to penetration or aspiration. The predictive model incorporating patient demographics and bolus presentation showed that delayed LVC by 0.1\u2009s or delayed LVO by 1% of the swallow duration (average 0.018\u2009s) was associated with a 17.19% and 2.68% increase in odds of airway invasion, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This predictive model provides insight into kinematic factors that underscore the interaction between the intricate timing of laryngeal kinematics and airway protection. Recent investigation in automatic noninvasive or videofluoroscopic detection of laryngeal kinematics would provide clinicians access to objective measurements not commonly quantified in VFSS. Consequently, the temporal and sequential understanding of these kinematics may interpret such measurements to an estimation of the risk of aspiration or penetration which would give rise to rapid computer\u2010assisted dysphagia diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2 <jats:italic>Laryngoscope<\/jats:italic>, 133:521\u2013527, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30222","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T12:01:32Z","timestamp":1654257692000},"page":"521-527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Temporal Sequence of Laryngeal Vestibule Closure and Reopening is Associated With Airway Protection"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3885-9091","authenticated-orcid":false,"given":"Kechen","family":"Shu","sequence":"first","affiliation":[{"name":"Department of Electrical and Computer Engineering, Swanson School of Engineering University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5509-8928","authenticated-orcid":false,"given":"Subashan","family":"Perera","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."},{"name":"Department of Biostatistics University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5928-5544","authenticated-orcid":false,"given":"Amanda S.","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5122-7497","authenticated-orcid":false,"given":"Shitong","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Swanson School of Engineering University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5627-5623","authenticated-orcid":false,"given":"James L.","family":"Coyle","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Swanson School of Engineering University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."},{"name":"Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."},{"name":"Department of Otolaryngology, School of Medicine University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4987-8298","authenticated-orcid":false,"given":"Ervin","family":"Sejdi\u0107","sequence":"additional","affiliation":[{"name":"Edward S. 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